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Epstein–Barr virus infection in children with renal transplantation: A single‐centre experience
Author(s) -
You Jihye,
Kim Mijin,
Lee Jina,
Han Duck Jong,
Park Young Seo,
Lee Joo Hoon
Publication year - 2018
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13162
Subject(s) - medicine , asymptomatic , transplantation , serology , epstein–barr virus , epstein–barr virus infection , single center , incidence (geometry) , gastroenterology , virus , immunology , antibody , physics , optics
Aim This study aimed to investigate the incidence, timing, manifestations, managements, and outcomes of Epstein–Barr virus (EBV) infection in paediatric renal transplant recipients in Korea. Methods We retrospectively evaluated 70 patients aged <18 years who had undergone renal transplantation between January 1990 and November 2014 at a single centre in Korea. EBV infection was diagnosed via serological test or real‐time quantitative polymerase chain reaction (PCR). The diagnosis of post‐transplant lymphoproliferative disorder (PTLD) was based on biopsy findings. Results In total, 21 patients (30.0% of renal transplant recipients) had EBV infection. EBV infection occurred at an average age of 12.6 ± 4.5 (median, 12.0; range, 7.0–24.0 years, with a mean period of 28.3 ± 27.2 (median, 14.0; range, 2.0–75.0) months for developing EBV infection after transplantation. EBV infection developed 12 times more frequently in pre‐transplant EBV‐seronegative recipients. Eight patients (38% of EBV‐infected patients) had EBV disease, and six patients (75% of patients with EBV disease) had PTLD. The maximum EBV PCR titer was greater in patients with EBV disease than in the asymptomatic EBV infection group. The main treatment for EBV infection was the reduction in immunosuppressants. Asymptomatic EBV infection resolved in approximately 80% of the patients. One patient (17% of the patients with PTLD) expired. The glomerular filtration rate did not deteriorate during the treatment of EBV infection. Conclusion Regular EBV monitoring in renal transplant recipients is mandatory for early diagnosis and treatment of EBV infections and prevention of PTLD, especially in pre‐transplant EBV IgG‐negative patients.